Award-Winning Author of Twirling Naked in the Streets and No One Noticed; Growing Up with Undiagnosed Autism shares her book, life, and insight into the mind of children and adults on the autism spectrum.

Recognizing Depression in People with Asperger’s Syndrome

Why is it sometime difficult to identify depression in those with autism spectrum disorders?

The difficulty may arise as a result of the inability or difficulty autistic individuals have expressing their emotions or communicating feelings of disturbance, anxiety or distress verbally. Depression is often missed until it is so severe that it hinders the ability to function. Many times it is difficult to verbalize, or even recognize these feelings. Without the ability to articulate clearly or recognize feelings clearly, practitioners need to rely on non-verbal communication; however, this is another area of difficulty for autistics. An autistic person with depression may not “appear” depressed to a physician that only sees them once every couple of months due to their impairment in non-verbal expression, and they may exhibit inappropriate affect.

What is inappropriate affect?

Inappropriate affect is when a person is saying one thing with their words but their facial expressions or body language is conveying a different story. When a person with autism or Asperger’s Syndrome finally finds the words to describe depressive feelings of despair, they may do so smiling. They will be unaware that they are smiling, and it certainly is not a smile of happiness. In fact, it could very well be a manifestation of nervous anxiety. When facial expressions and body language, communication tools that are relied upon by practitioners, are inconsistent with reported feelings, or the feelings are not reported due to verbal communication barriers it can be difficult to identify the depression. Furthermore, depression may actually manifest itself differently in these individuals.

Depression without sadness?

Depression can still be present in those with Asperger’s Syndrome even without the telltale signs of feelings of sadness. It often presents itself through avoidance. The autistic version of depression is dominated by apathy, and profound inertia that can make it hard to approach tasks. They may struggle with avoidance when it comes to everything from personal hygiene, shopping, household chores, or work projects. They display no motivation to perform these tasks, or wait until the last possible moment to complete assignments or projects all the while mentally running in circles with the task looming overhead. Feelings of anxiety and dread at the thought of completing even the simplest tasks may accompany their avoidance. Avoidance, for those on the autism spectrum, can be a powerful symptom of depression.

Treatments for Depression in Asperger’s Syndrome:

Many of the treatments to combat the feelings of sadness associated with depression tend to be ineffective when it comes to depression coupled with autism. Psychotherapy, although effective for some, can often be only a short-term solution for those on the autism spectrum. The idea of feeling better by just “talking about it,” can work but is usually only effective during the actual therapy session and rarely last past that period of “talking.” It is as if that time-period occurs in a vacuum, and the information is not held in the mind past the present. Behavioral therapy is another option which can be useful; however, it is important to be aware that many times avoidance is a symptom whose roots are in feelings of meaninglessness. If the tasks given during behavioral therapy are perceived as meaningless or purposeless, it may actually exacerbate avoidance symptoms. A good option for treatment, at least in the short-term, involves learning of some fashion and is often linked to the person’s “special interests.” Working on one’s special interests can bring feelings of meaning, happiness, purpose, and relaxation.

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Jeannie Davide-Rivera

Jeannie is an award-winning author, the Answers.com Autism Category Expert , contributes to Autism Parenting Magazine, and the Thinking Person's Guide to Autism. She lives in New York with her husband and four sons, three of which are on the autism spectrum.

Excellent article. Another thing that many people not on the spectrum do not understand is that many autistics will look sad or depressed when feeling nothing in particular. When they are not feeling any emotion their face is totally relaxed (no muscles in use) whereas many typical people seem to retain some form of expression. The lack of expression makes it difficult for people to understand what the Autistic person is feeling. For me as a parent it has always been a difficult thing to recognize the difference between depression (short term really is what I am speaking of) and the in between feeling with a lack of expression.